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Urinary albumin strip assay as a screening test to replace quantitative technology in certain conditions

  • Maria Salinas EMAIL logo , Maite López-Garrigós , Emilio Flores , Javier Lugo , Carlos Leiva-Salinas and on behalf of the PRIMary Care-LABoratory (PRIMLAB) working group
Published/Copyright: July 19, 2018
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 57 Issue 2

Abstract

Background

The clinical laboratory plays a crucial role in the diagnosis and monitoring of chronic kidney disease. The quantitative measurement of urine albumin in a spot sample, expressed as ratio per creatinine (ACR) is the most frequently used biomarker for such a purpose. Our aim was to evaluate the diagnostic performances of a strip for measuring ACR for differentiating patients who are candidates for subsequent albumin quantification, and to evaluate the economic effects of its implementation.

Methods

We systematically measured strip analysis when quantitative urinary albumin was requested. Semiquantitative urinary albumin was measured using a UC-3500 (Sysmex, Kobe, Japan), based on the protein error of a pH indicator. We collected and reviewed all the values of quantified urinary albumin and their corresponding results in ACR strip tests. We calculated the diagnostic indicators for ACR at different albumin and creatinine values using the quantitative ACR measurement as a “gold standard”. We also studied the economic effects based on both tests prices (€1.31 for quantitative albumin plus creatinine, and €0.04 for an albumin strip).

Results

The study included 9148 patients (mean age 63, 46.3% men). The results at different albumin and creatinine cutoffs showed the best performance when 10 mg/L and above 50 mg/dL, respectively. Based on our results, we would have saved 3506 urine albumin and creatinine tests in the study period, corresponding to €4226.94.

Conclusions

The present study supports the use of the ACR strip test to identify pathological albuminuria values to be measured through quantitative methods. Considerable economic savings are possible.

Keywords: albuminuria; chronic kidney disease; test strips
Corresponding author: Maria Salinas, PhD, Clinical Laboratory, Hospital Universitario de San Juan, Carretera Alicante-Valencia, s/n, 03550 San Juan de Alicante, Alicante, Spain, Phone: +34 965169463, Fax: +34 965169460

Acknowledgments

Members of the PRIMLAB working group are the following: Beatriz Massa-Dominguez (Chief Executive); Antonio Gómez-Gras (Primary Care Director); Norma Iranzo (Medical vice-director); Alejandro Canals-Baeza (CS Santa Faz-Ayuntamiento); Jose L. López-Blasco (CS Hospital Provincial-Plá); Esperanza Gonzalez-Alvaro (CS Juan XXIII); Ramon de Juan Francés (CS Cabo Huertas); Jordi Gisbert-Segura (CS Campello); Rosario Oliver-Ros (CS Xixona); Alberto Asencio-Aznar (CS Mutxamel); Juan J. Ballester-Baixaulí (CS Sant Joan) and Carmen Pardo-Tomas (CSI Gerona).

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-05-24
Accepted: 2018-06-15
Published Online: 2018-07-19
Published in Print: 2018-12-19

©2019 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

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  2. Obituary
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  4. Editorial
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https://doi.org/10.1515/cclm-2018-0546
Keywords for this article
albuminuria; chronic kidney disease; test strips

Articles in the same Issue

  1. Frontmatter
  2. Obituary
  3. Jillian Russyll (AKA Jill) Tate
  4. Editorial
  5. The long way to standardization of practices: HbA1c as archetypal example
  6. Reviews
  7. Secretory tumors of the pituitary gland: a clinical biochemistry perspective
  8. Thalassemia in the laboratory: pearls, pitfalls, and promises
  9. Opinion Paper
  10. Diagnostic biomarkers of muscle injury and exertional rhabdomyolysis
  11. General Clinical Chemistry and Laboratory Medicine
  12. Patient’s knowledge and awareness about the effect of the over-the-counter (OTC) drugs and dietary supplements on laboratory test results: a survey in 18 European countries
  13. National surveys on 15 quality indicators for the total testing process in clinical laboratories of China from 2015 to 2017
  14. Urinary albumin strip assay as a screening test to replace quantitative technology in certain conditions
  15. Cerebrospinal fluid free kappa light chains and kappa index perform equal to oligoclonal bands in the diagnosis of multiple sclerosis
  16. Different immunoreactivity of monomers and dimers makes automated free light chains assays not equivalent
  17. The utility of saliva testing in the estimation of uremic toxin levels in serum
  18. Determination of cannabinoids in oral fluid and urine of “light cannabis” consumers: a pilot study
  19. Moving from the second to the third generation Roche PTH assays: what are the consequences for clinical practice?
  20. Baseline hepcidin measurement in the differential diagnosis of anaemia for elderly patients and its correlation with the increment of transferrin saturation following an oral iron absorption test
  21. Reference Values and Biological Variations
  22. A multicenter study for the evaluation of the reference interval for TSH in Italy (ELAS TSH Italian Study)
  23. Cancer Diagnostics
  24. Urinary measurement of circulating tumor DNA for treatment monitoring and prognosis of metastatic colorectal cancer patients
  25. BCL2L12: a multiply spliced gene with independent prognostic significance in breast cancer
  26. Diabetes
  27. The global impact of the International Federation of Clinical Chemistry and Laboratory Medicine, Education and Management Division: engaging stakeholders and assessing HbA1c quality in a multicentre study across China
  28. The frequency of testing for glycated haemoglobin, HbA1c, is linked to the probability of achieving target levels in patients with suboptimally controlled diabetes mellitus
  29. Letters to the Editor
  30. Response to article by Caponi et al. about serum free light chains
  31. Response to Letter to the Editor about immunochemical measurement of urine free light chains
  32. Estimated GFR-specific 99th percentiles for high-sensitive cardiac troponin T based on the adjusted analytical change limit (adjACL) in hospitalized patients
  33. Perioperative heart-type fatty acid binding protein concentration cutoffs for the identification of severe acute kidney injury in patients undergoing cardiac surgery
  34. A peculiar reaction curve with dual spikes in absorbance during a total bilirubin assay in spite of accurate results induced by high M-protein concentration
  35. Extremely low high-density-lipoprotein cholesterol due to an unusual non-inherited cause: a case report
  36. A single-center performance evaluation of the fully automated iFlash anti-Müllerian hormone immunoassay
  37. Genetic polymorphisms and variants in the LDL receptor associated with familial hypercholesterolemia: cascade screening and identification of the variants 666C>A, 862G>A, 901G>A, and 919G>A of a Brazilian family
  38. Undetected paraganglioma by functional imaging techniques: case report
  39. A particular case of AML patient with the polymorphism G105G (rs11554137) and the missense mutation R132C in IDH1 gene
  40. Atypical “hairy cell-like” presentation of leukemic mantle cell lymphoma
  41. Evaluation of a rapid centrifugation step (4500 g for 2 min) in coagulation assays to monitor direct oral anticoagulants
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